Queens Dental Sleep Medicine, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

QUEENS DENTAL SLEEP MEDICINE, LLC

Doing business as

Koala Center for Sleep Disorders NY-2

Practice address

3560 74TH St # 103a
Jackson Heights, NY 11372-4316

Phone

(718) 683-9040

NPI assigned

Aug 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lily W. Eng, DDS

Title

Owner

Phone

(718) 683-9040

Specialties & licenses 1

Addresses

Other names 1

• Koala Center for Sleep Disorders NY-2 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502668800000",
    "number": "1972029742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 N. STATE ROUTE 40",
            "address_2": "STE 100",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "61525",
            "telephone_number": "309-376-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 74TH ST # 103A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113724316",
            "telephone_number": "718-683-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS DENTAL SLEEP MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-14",
        "last_updated": "2017-08-14",
        "status": "A",
        "authorized_official_last_name": "ENG",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-683-9040",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala Center for Sleep Disorders NY-2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.